White Paper

White Paper 2019-07-05T21:44:10-04:00

 

CONTENTS

 

  • Introduction   
  • Overview of Human Performance
  • The Problem
  • Our Solution
  • Testing and Validation
  • Practical Application
  • References

 

 

INTRODUCTION

The mission of 1109 Bravo is to optimize the human weapon system with our innovative Neuropak technology in order to improve warfighter biomechanics, accelerate skills proficiency, reduce musculoskeletal injury, and ultimately improve lethality, resiliency, and readiness. 

Human Performance has increasingly become an important priority for military, paramilitary and occupational training and other strenuous high-risk occupations.  However, with conventional training methods individuals must choose between using traditional resistance training (that produce a significant risk of over-training, leading to potential injury) or repetitive tactical drills to keep them mobile and proficient.  Current protocols may engage the on-market apparatuses that are stationary and offer little to no functional mobility opportunities. These products are typically tethered to a base or wall and restrict the individual’s natural performance patterns. 

Stationary devices also make it impossible to provide occupational training in a mobile simulated real-world environment in which small units must execute training in teams. The Neuropak, a body-mounted device, bridges the gap between traditional resistance training and truly allows an unrestricted user-defined performance pattern improvement. The wearable neuromuscular training device provides opportunities for the user to reduce injury, correct biomechanical imbalances, and train in the most individualized manner possible. 

The patent to the 1109 BRAVO Wearable Performance Training System (Neuropak) describes a resistance training apparatus and method for providing a plurality of training vectors having the point of origin fixed on the trainee via any combination of the following: a Modular Lightweight Load-carrying Equipment (MOLLE), backpack, bodysuit, waistband, belt, wristbands, armband and/or leg bands providing a mobile system for wearable resistance. The apparatus accommodates a single trainee and provides multiple training vectors for a broad range of functional movement and specific performance patterns that are uniquely adjustable for their specific body size and frame. The apparatus provides the training vectors by attaching tethers to attachments worn around body portions of a trainee in a configuration that allows the trainee to perform unrestricted sports-specific, occupations-specific or therapeutic movements at an optimum speed and unencumbered due to the wearable aspect vs. being anchored to a fixed platform.  In one embodiment, the apparatus includes a wearable base unit forming the resistance housing providing cables or cords for attachment to the training accessories worn by the trainee. Each of the cables or cords providing the training vectors are independently adjustable such that balanced or unbalanced loading may be applied simultaneously to a trainee. Training using these methods can increase both neuroplasticity and proprioception in the trainee compared to contemporary methods of resistance training.  With the individual body mounted device the trainee can now enter high stress and close quarter team training scenarios which is a key variable in developing truly conditioned neuroplasticity by the introduction of all senses, smells, and physiological hormone release.  Whereas, other training methods are restricted to a base platform or wall attachment and is not conducive to movement-based team tactics.

 

OVERVIEW OF HUMAN PERFORMANCE 

A great deal of the scientific research and academic dialogue related to human performance has been focused on neuroplasticity—the concept that neural connections in the brain change, remap, and reorganize themselves when people learn new concepts, have new experiences or practice certain skills over time.

Scientists have also determined, for example, that the brain can perform several activities at once; that the same information can be stored in multiple areas of the brain; that performance functions can be affected by diet, exercise, stress, and other conditions; and that “meaning” is more important than “information” when the brain is learning something new. 

When combining the principles of neuroplasticity and proprioception (the body’s awareness of its movements) one begins to understand how to optimize skill development through physical conditioning. 

Neuroplasticity, also called brain plasticity, is the process in which 

your brain’s neural synapses and pathways are altered as an effect 

of environmental, behavioral, and neural changes. Neuroplasticity 

reprograms the body’s central nervous system, allowing for faster 

reflex signals under circumstances such as critical skill performance 

or environmental conditions like fatigue. 

Proprioception is the ability for joints and limbs to sense stimuli arising within the body regarding the position, motion, and equilibrium. Even if a person is blindfolded, he or she knows through proprioception if an arm is above the head or hanging by the side of the body. 

Current methodology for improving proprioception includes weight bearing of the extremities during exercise using traditional weights or banding while performing repetitive skill drills or by conditioning associated joints and muscles using traditional exercise protocols. 

These traditional exercise protocols often exacerbate injuries or imbalances and after prolonged or repetitive use may lead to a deterioration of physical ability due to their inability to stabilize core muscle groups. Co-contraction is a condition in which muscles around a joint contract simultaneously to provide stability. Activating core and stabilization muscles groups during a sport or job-specific activity improves muscle and joint endurance as well as performance during live sport or job-specific activities.

Proprioceptive Neuromuscular Facilitation (PNF) refers to the sensory receptors that provide the brain with information concerning movement and positioning of the body, as well as the nerve and muscle reaction that responds toward normal functioning. Each muscle group has a diagonal, which is a mass movement pattern characteristic of normal activity, and each diagonal contains three components of motion: extension/flexion, abduction/adduction, and rotation. By triggering Proprioceptive Neuromuscular Facilitation (PNF), the body can learn corrective functioning and new skill development in a faster and safer manner. 

Human performance can be optimized when tactile input is delivered to key muscles and joints during the activity of a sport or job-related task. Tactile input allows the individual to better train the correct positioning and activation of the muscle groups being used in a specific activity. The proprioception of those associated joints and muscle groups will allow for training during the actual activity, thus optimizing the speed in which the muscles will react under similar stimuli. 

The key to developing safer protocols for human performance may be found in the intersection of neuroplasticity, proprioception and co-contraction by building a human performance solution that enhances the brains natural reflex signaling while providing stabilization and tactile input to key muscle groups. 

 

THE PROBLEM

Human movement training has not changed in decades—athletes train in the gym, or people undergo therapy in clinical settings, and then try to translate those efforts into the authentic environment of the court, field, work, or life. Unfortunately, these traditional approaches and rehabilitation methods cannot replicate the skill-based competencies required for live competition or activities of daily living because they do not equally engage the body and neurological responses. The concept of unequal engagement of neurological response has burdened efforts applied in performance, military, wellness, and rehabilitation/healthcare. 

The current approach to human performance optimization has improved in recent years, primarily due to the ability and availability of technology to more accurately measure and track key metrics to manage injury risk and individual performance.  This information can be used for more appropriate periodization of training programs and recovery schedules but unfortunately does not prevent the underlying causes neither acute nor chronic injuries. Unfortunately, the current tools do not allow for the full development of skills through improved biomechanics in a truly task- specific user-defined way.  

Traditional strength and conditioning protocols do not allow

for natural skill development or task-specific training.

Task-specific training is critical to human performance optimization. A biceps curl merely builds a stronger biceps, it does not translate into a faster draw of one’s weapon. As such, an Olympic squat does not translate into better running mechanics- it can only build a stronger muscle group. Of course, strength and conditioning programs are still incredibly valuable and play a large role in human performance efforts but the only way to truly optimize performance is to train movements- both dynamic and fine motor control.  

 

 

Our Solution 

The 1109 Bravo team developed a lightweight, easy- to- use wearable corrective training device that applies continuous, calibrated resistance to the limbs using user-defined attachment points. The device is constructed with specialized dynamic cords that extend from the device and attach to the user’s limbs in multiple configurations. This proprietary design facilitates the adaptive neurological responses of skills-based training while applying continuous, active resistance throughout all ranges of motion to improve every aspect of training without impeding natural movement. The Neuropak was created with the original purpose of letting warfighters train like they fight: training not only their bodies, but also the neuromuscular responses critical to skills-based activities. 

The Neuropak training system is the first solution that bridges the gap between functional skill-specific performance training and corrective exercise (injury rehab/prevention) as a single comprehensive platform. This unrestricted training system improves performance in authentic training environments- improving the quality of movement, reducing the risk of injury, and offering a simple yet robust tool that quickly and effectively helps any user move better. 

The Neuropak increases the activation of the neuromuscular response associated with any skills-based activity via applying continuous, calibrated resistance to the user’s limbs in a novel, robust, and user-defined manner. The application of this resistance improves neural plasticity and adaptation associated with muscle memory and stabilizes and conditions muscle groups to improve movement quality and reduce injury risk. By engaging the midline stability muscular and optimizing posture for movement with a neutral spine during skills-based training, then communications across the kinetic and neurological chain will be vastly improved. This will allow for faster reaction, ground force application, improved structural balance for injury mitigation and overall performance in any physical application.

Developing neuroplasticity and increasing proprioception are powerful capabilities for any training system, but 1109 Bravo’s NeuroPak allows for these improvements in a fraction of the time of more traditional methodologies. It does so by taking a more comprehensive approach to affect both the aerobic/anaerobic energy system for conditioning fitness as well as skill competencies for directly improved accuracy in any skill training. This made possible in large part by the previously aforementioned engagement of midline stability musculature, thus allowing for improved communications across the kinetic and neurological chains 

These improvements happen organically, through skill-specific movement without over-taxing the wearer’s central nervous system (CNS). While not over-stimulating, the added resistance and continuous, non-invasive activation of targeted musculature (activated musculature dependent upon how the system is being worn) allows for induced fatigue protocols. Teams can identify individual’s proficiencies against their teammates which provides the individual and the entire team an opportunity to be confident that each member is dialed in at the same level. It allows not just an individual but the entire team to asses while they train. Additionally, the Neuropak system allows for the identification of biomechanical deficits such as right-hand dominance or external rotation of the knee. Using the Neuropak, individuals have the ability to rehabilitate and correct any deficiencies during their normal training regimen. 

The Neuropak is 2.5 lbs. and created from carbon fiber and titanium. Each unit is built and adaptable to heights ranging from 5’5” to 7’ with no additional modifications. The resistance has a very low level of hysteresis, also known as even tension, and provides the CNS with smooth loading not to disrupt or overload the skill pattern by sending varied signals to the motor neurons. It was modeled after the human developmental sequence, representative of human development from infancy to adulthood- achieving some movement, trunk control, then movement of the extremities on a stable trunk and lastly, skilled activities. 

 This wearable training system supports and accelerates the human body’s natural ability (homeostasis) to adapt, learn and grow in the dynamic environments that may be required through neuromuscular engagement by nature of training in the skills needed for any specific sport or occupation. Rather than practicing a disconnected series of movements or exercises, the user can condition cardiovascular fitness along with conditioning the nervous system, brain and endocrine system (regulates hormones) specific to critical skills. This whole-body protocol allows for more efficient skill-specific conditioning and overall improved health. 

Benefits of the Neuropak include robust neuromuscular reeducation leading to increased power, lasting endurance and resiliency, and better coordination and kinesthetic awareness. It also the user to repeat motion with less effort and concentration for extended periods and achieve maximum force in a desired direction due to the relaxation of antagonistic muscles. The Neuropak transitions users away from ineffective training methods and poor habits;, instead developing strength, endurance and resiliency. It has been shown to improve all ranges of motion and enhances posture by intrinsic stabilization of the core and spine.  

Intuitive self-correction of unsafe movement patterns is also a benefit of the Neuropak. It directs skill performance toward correct methodology, reducing injury and allowing for effective and efficient task performance from a brief two-week adaptation period. The Neuropak also rehabilitates in a functional way specific to the type of injury. It eliminates ineffective rehabilitation methodology, instead focusing on a positive treatment approach using tasks which the user can accomplish. Injury rehabilitation using the Neuropak allows the nervous system to be reconditioned towards safe movement patterns allowing the neurons to trust the safe pattern again and ultimately leading to reduced incidents of reinjury. 

 

 

TESTING AND VALIDATION

 

 

DoD Validated Motion Analysis Study

 

 

3-D Motion Analysis Study

In an initial test-retest validation study of the Neuropak in a validated markerless motion analysis system, the device demonstrated statistically significant improvements in mobility, stability, performance, asymmetry, and movement quality by an average margin of 30.25% increase over baseline after just one use.

The Neuropak method provides an efficient, effective, and user-friendly approach to human performance, rehabilitation, or injury prevention: Simply wear the device, and move better. This approach improves muscle memory without constraining the activity itself or preventing the execution of smooth, natural movement. The ability to “train how you play/fight/work/live” for athletes, military personnel, workers, those trying to recover from injury or disease, or anyone just living their daily lives, will fundamentally shift the paradigm of training, recovery, and healthy human movement in general.

 

Global Test Results

After a single use, the Neuropak demonstrated an average of 30.25% improvement across all major categories:

  • Mobility (defined as improvements in range of motion)
  • Performance (improvements in squat depth and jump height)
  • Stability (defined as improvement in control of the body by limiting deviations from the primary plane of movement)
  • Motion Quality (defined as improvement in the quality of movement by minimizing asymmetry and minimizing vulnerability to injury)

This means after one single use, the Neuropak improved the quality of movement as well as reduced the risk of non-contact soft-tissue injury, both by 30.25%

 

Jump Height Improvement

Vertical jump 3.25” increase
Drop jump 0.8” increase
Left leg unilateral squat depth 5” increase in depth
Right leg unilateral squat depth 1” increase in depth

Neuropak Validation Benefits at Each Joint (After one use)

Shoulder
Mobility Improved 23.38% in all planes
Asymmetry Reduced by 66.21%
Spine
Mobility Improved by 43.77% in all planes
Dynamic Control Improved by 27.45%
Asymmetry Reduced by 36.74%
Hips
Mobility Improved by 17.27%
Dynamic Control Improved by 16.62%
Asymmetry Reduced by 53.38%
Knees
Mobility Improved by 10.89%
Dynamic Control Improved by 38.23%
Asymmetry Reduced by 54.06%
Ankles
Mobility Improved by 17.62%
Dynamic Control Improved by 29.17%
Asymmetry Reduced by 26.03%

 

 

 

 

 

 

Neuropak Validation Key Takeaways:

  • Neuropak has immediate, beneficial effects on human movement quality and biomechanical performance.
  • Reduces injury risk and improves skills-based competency with one robust training system.
  • Immediate improvement in the quality of movement means an immediate reduction in injury risk, yielding better biomechanics that translates to better movement, for longer. Less injury, more stability yields longevity.
  • Immediate improvement in the performance of the movement means immediate benefit for creating muscle memory/neural adaptation to hone skills-based activities.
  • Immediate improvement relative to baseline indicates that the Neuropak can accelerate training and more effectively translate training into the better execution of skills-based activities after a single use.
  • Further study is needed to document the cardiovascular benefits of the device, although it will obviously have a positive effect on cardiovascular training.
  • The Neuropak has applications in any skills-based proficiency or human movement application: performance/tactical training, rehabilitation, physical therapy, general motion health/lifestyle.

 

Running Study

 

 

Initial Product Testing

On Friday 7/14/17 at the Warrior Expo in Virginia Beach, Joel Huntgate, the VP of Orthopedic Programs at DARI tested the device and submitted reports on the Function Motion Analysis. The results were as follows:

  • DARI without 1109 DEVICE scored a HIGH of 55 on the dysfunction scale
  • DARI with 1109 DEVICE scored immediate correction to a LOW of 37 on the dysfunction scale

Below you will observe the DARI functional movement analysis video capture:

 

“If you can identify a biomechanical asymmetry and correct it in a truly functional way then you will dramatically reduce the potential for INJURY and exponentially increase your PERFORMANCE in any specific pattern.  Furthermore, you can rehabilitate an injury in a truly functional way which will ALWAYS have better outcomes.”

Joel Hungate- DARI Vice President, Orthopedic Programs                                                  DARImotion.com

“Comparing both reports will allow your team to see the biomechanical effect your device had immediately on some core, functional movements that I performed in the system. Some impressive, immediate findings I noted: Your device incurred a significant increase in my core stability during unilateral balance testing (especially considering I exhibited solid balance before donning the device!), and improved my stabilization during control of my center of mass, hips, knees, and ankles on both lateralities, in both the M/L plane and A/P plane. Your device also immediately eliminated some asymmetries I exhibited in the unencumbered scan–namely at my knee and spine. Likewise, looking at the smoothness of my motion data curves, your device did not have a significant effect on my ability to perform any planar ROM (save for some spinal rotation limitation due to impingement), nor did it have any effect on my ability to achieve comparable squat depths. The smoothness of the motion was a surprise to me and is a testament to your design not incurring “jerky” patterns while in use by an operator.
Also of note, the device obviously had an effect on my jumping ability (due to the extra tension and weight) but that is the point of having it on in the first place. Also of note, my unilateral kinetic chaining was not encumbered with the device, though I would have to repattern my kinetic chaining to accommodate the device during my bilateral vertical jump–but once again I think that is the point behind training with a new layer of neuromuscular stimulation.
All in all, I was thoroughly impressed with the freedom of movement throughout the functional motion analysis, and the “opening up” that the device incurs in spinal and core stability, which made an immediate difference. Likewise, I was impressed with my ability to perform even while fatigued from the unencumbered scan and still maintain smoothness and ROM.
Regarding my right hip being flagged on the “instant motion report”–
Any biomechanical “flags” that you see on the “instant motion report” represent my body’s source of compensation for the device (i.e. right hip being red) and would improve with training. Really, I’m impressed it didn’t cause more up-or-down chain compensations.”
Best,

Joel Hungate
VP of Orthopedic Programs- DARI

 

 

Practical Application 

Unrestricted performance patterns are specific to the individual athlete and directly applicable to the critical skills needed in the real-world environment. The Neuropak has been utilized in simulated virtual ranges, live ranges, QCB, team training and in force-on-force applications. In addition to the benefits of physical fitness and injury prevention, the Neuropak has also demonstrated physiological benefits such as nervous system conditioning under stress conditions such as Shoot or No Shoot scenarios. 

The Neuropak also allows for real-time training on core competencies such as Team QCB, breaching, shot fatigue, accuracy under an increased fatigue protocol, time on target, reaction time, speed reloads, transition drills, and hand-to-hand combatives.  

The benefits of the 1109 Bravo Neuropak device include:

  1. Neuro-Cognitive Learning – Accelerated Performance-Based Learning, Decision-making process, shoot/no shoot scenarios.
  2. Neuromuscular Conditioning – Quicker reaction and sustainability of any critical skills.
  3. Neuromuscular Re-education – Increases power, provides lasting endurance, better coordination, ability to repeat maximum force in the desired direction with less effort and concentration.
  4. Training Efficiency – Transitions users away from ineffective training methods and bad habits, develops strength and endurance, new ranges of motion, enhances posture, refines and conditions critical skills.
  5. Injury Prevention – Self-corrects movement patterns that create injury and reduce performance, directs skill performance toward the correct methodology that reduces injury and allows for effective and efficient performance.
  6. Aerobic/anaerobic energy system conditioning of the cardiovascular system – Due to an intense co-contraction that the device places on the kinetic chain throughout the body simultaneously, there is an increased demand and conditioning of the cardiovascular system to drive blood and oxygen throughout the body to all the contracting muscles.
  7. Force Coupling of the muscles by activating “muscle groups” rather than an isolation exercise. This will ultimately increase stability in the joint or region that is engaged, increase proprioception, and decrease the likelihood of injury. 
  8. Core Competencies – Shot fatigue, accuracy under an increased fatigue protocol, time on target, reaction time on shoot no shoot drills, speed reloads, transition drills.

 

Practical Application: Military Usage Guide Sample

Introduction

A special forces sniper, canine command, and amphibious operator. What do these military professionals have in common? They are all elite-level athletes that require a robust physical training regimen.   

Traditional training programs are based off a periodized schedule and are designed with macro and micro training phases.  This develops specific training adaptions such as strength, power, and aerobic fitness but does not take the demands of an elite combat athlete into account.  A smarter approach must be taken to create a superior combat athlete. 

With the high demands of a critical skills operators we must find a better strength and conditioning strategy to give the operators an elite level of sustainable fitness and a reduced rate of injury. 

Application

The mission of any given operator may, and often does, place them in rapidly changing environments and levels of activity. For example, an operator may be charged with a HALO insertion into an amphibious environment and then a 10-mile ruck to their primary objective. At this point they will enter a high intensity critical skills phase of their mission. While periodized programs work the anaerobic and aerobic energy systems they lack the integration phase that allows an operator to draw on either system on-demand. 

Sustained training on the TRT will build and condition all three muscle fiber types but ultimately will build added neuromuscular development. This training will have a direct effect on the operator’s critical skills such as A-zone accuracy under tension, speed reloads, time on target, lateral quickness and agility, transition from primary to secondary weapon systems, and improve shot fatigue. 

With this unique approach to time under tension, the operator will train both the anaerobic and aerobic energy systems while also developing the ability to call on all three muscle fiber types under great stress and fatigue.  Traditionally, Olympic lifts were used to test and build maximum weight lifting ability with detrimental consequences such as fatigue and injury. The TRT approach has less impact, leading to less injury and a more sustainable time in service.

Testing

Testing is done to measure baseline training ability in the developed exercise program and allows for incremental re-testing as needed.

Testing measures force during all static positions, the length of time the operator can sustain position under force, the length of time it takes to finish the program, and pain complaints. Testing is done via force dynamometers to measure push and pull force and to measure the operator’s ability to hold static positions without breaking. 

 

 

Practical Application: After Action Review: Neuropak Training System Live Fire Test 1

The initial Live Fire training evaluation of the Neuropak system was conducted on Thursday, October 20th, 2016. Participants were Chris Tedesco and Jim Carter representing 1109 Bravo LLC. The location was the Rockcastle Shooting Center in Morgantown, KY. The test period occurred over a 6-hour period which included check in at the range complex, equipment and target set up, physical/unarmed application demonstration, live fire evaluation, and clean up/check out.

The purpose of the test was to demonstrate the ability to place an operator in a fighting load on the Neuropak and execute safe, effective, and relevant training in a live fire range environment. Along with the primary focus came the additional task of evaluating the Neuropak as a piece of equipment that can be easily moved out of the controlled environment of a training gym and placed on a vehicle, loaded and offloaded with only manual labor level support. Linked to that purpose was to evaluate whether the Neuropak system was rugged enough to be employed in a “field environment” where dirt, debris, and muddy conditions are typical.

The Live Fire portion was the main effort of the exercise and is, therefore, the chief focus of this review. The goal was to demonstrate the ability of an Operator while attached to the Neuropak: to move forwards, backwards, and laterally, to safely and accurately employ both the primary and secondary weapon systems, and to evaluate any potential hazard presented by attachment to the Neuropak such as entanglement.

To capture an adequate demonstration of necessary skills we designed a simple course of fire (enclosed with other materials) that addressed the expected versatility of the Neuropak platform linked to firearms training. The two drills required the operator to maneuver a given distance to an engagement point and fire a set number of rounds at a static, multiple target array. During a given engagement, the operator would encounter a stoppage of his primary weapon system that would trigger an emergency action such as a speed reload or a transition to the secondary weapon system. Constraints applied to the operator were avoiding entanglement in the Neuropak cable system and maintaining an acceptable level of accuracy during each set of drills. There was no time constraint applied for this specific evaluation in the interest of safety as well as an agreement that this exercise was a proof of concept rather than an evaluation of speed and accuracy on the part of the operator.

For the weapons manipulation portion, the operator donned full PPE, fighting load, and primary and secondary weapon systems. Both drill sequences were then conducted one iteration per sequence in the interest of checking for any possible safety conditions that might occur, as well as allowing the operator to gain familiarity with the level of resistance being produced by the Neuropak. No issues were encountered during this portion of the evaluation and the operator could successfully, safely, and smoothly execute all necessary skills.

The live fire portion, consisting of 4 runs per drill, 3 under tension and 1 free was executed next. The operator removed his helmet but conducted the drills with all other PPE, equipment, and weapon systems utilized in the dry run through. The operator then executed 4 iterations of the two individual drills – Speed Reload and Transition to Handgun. Apart from avoiding any safety issues linked to the Neuropak the only constraint levied upon the operator was to maintain 100% accuracy with all impacts inside the “A zone” of the 3 targets. The operator maintained 100% A Zone accuracy with his primary weapon and 98% A Zone accuracy with his secondary weapon system over the 8 individual runs. All impacts from both weapon systems were on paper and on target within a “combat effective” zone with a 0% verified miss rate. The operator encountered 0 weapon malfunctions and 0 issues maneuvering while under tension from the Neuropak.

Following the 8 runs, the operator performed a lateral movement engagement on the target area moving back and forth between two positions and engaging the target array continuously. The same burden of safety was applied as was the maintenance of “combat effective” accuracy. The purpose here was to demonstrate the ability to move laterally under tension and utilize different firing positions without becoming entangled in the cable system. The operator executed the sequence moving from position to position multiple times while engaging the target array, executed multiple position changes and speed reloads and encountered no issues with the cables hanging up on his equipment or entangling him.

Overall, the evaluation was successful across the board. The Neuropak handled the wet and muddy conditions excellently and was easily cleaned and returned to an acceptable level of appearance within the training facility with a minimum of labor. The belt and collar devices were adequate for the evaluation and created no issues for the operator other than the occasional requirement for assistance while being clipped in. Both participants agreed that the arm collars (though adequate for the test) would provide greater benefit and ease of use if they were to attach at the elbow rather than around the hand or wrist/forearm.

 

 

Combat Arms Manual/ Sample Drill

(LIVE FIRE DEMO)

  • The target array for this event will be 3 IDPA/USPSA cardboard targets 1 meter apart, on line, at 10 meters from the firing point. Targets numbered 1-3 from left to right.
  • On the buzzer, Shooter will advance to Firing Point in order to achieve a desired level of resistance and begin the engagement drills.
  • Movement to Firing Point with carbine at Alert/low ready position.

Drill 1: Multiple Target Engagement with Speed Reload and Re-Engage.

Buzzer initiates Shooters movement to the Firing point as described. Shooter will engage Target 1 with 5 rounds from the standing position turning torso left and bringing weapon up to eyes then firing as fast as possible to maintain “A-zone” accuracy. Shooter will then drive weapon (still in firing position) to Target 3, torso twist right, and engage with 5 rounds from the standing position. At this point, the weapon will run dry and trigger a speed reload for the shooter.

(Torso rotates back to center. Firing arm brings weapon to workspace/chicken wing position. Support hand detach/search/retrieve full magazine then loads and charges weapon. Shooter then re-acquires firing grip on weapon and drives weapon back into firing position.)

When the reload is complete, the Shooter engages Target 2 with 5 rounds as fast as possible to maintain “A-zone accuracy”. Shooter then conducts “tank turret” search and assess, then lowers weapon, searches left-right-rear, then steps off Firing point to cut tension. 

 

 

Orthopedic Testing and Injury Prevention Model

 Tactical / Combat testing and training program         

Example 1:

Bridging the gap for in-combat training by merging physical therapy functional testing and injury prevention with 1109 Bravo’s functional exercise training programming.

Example 2:

By taking 1109 Bravo’s functional training program combined with Focus Physical Therapy functional assessment and injury prevention, we bridge the gap to make a more complete elite athletic solider.

Purpose:

  1. To quantify and identify risk factors during typical tasks of those training in the military or any tactical force.
  2. Provide methods to test baseline ability to perform task and quantify physical demands.
  3. Provide methods to retest ability to show progress with training decrease risk factors for the physical breakdown.

Components:

The following are options and can be tailored to meet the specific needs of the job and the participant.

  • Develop essential job demand analysis
    1. Specific to tasks being performed across the board
    2. NO general demands
    3. All forces, grip and lifting requirements are measured
    4. Reference example: http://www.pubpdf.com/pub/26461861/Employment-Standards-for-Australian-Urban-Firefighters-Part-1-The-Essential-Physically-Demanding-Tas
  • Full physical therapy exam to ID:
    1. Range of motion or flexibility deficits in all body parts
    2. Joint integrity of all joints
    3. Use special testing to rule out common musculoskeletal conditions
      1. i) E. Rotator cuff impingement, UE/LE neural tension, crepitus for cartilage damage in knees, etc.
    4. Neural screen (DTRs, Myotomes, Dermatomes)
    5. Full strength testing
      1. i) UE, core, and LE
      2. ii) Balance testing
  • iii) Dynamic balance testing
  • Force gauge static testing.
    1. Static UE, Core and LE force measurement
    2. Pull and Push max force
    3. Lift max force
    4. Grip testing
  • Functional testing
    1. Develop test based on essential job demand analysis to ensure user ability.

Additional testing protocol to measure baseline training ability in the developed exercise program and retest:

  1. Resistive test via 1109 Bravo’s wearable training platform to measure:
    1. Force during all static positions
    2. Measure length of time participate can sustain position with that force
    3. Measure length of time participate can finish program
    4. Measure and assess any pain complaints
  2. Equipment needed
    1. Force dynamometer to measure push and pull force given by training platform and to measure participant’s ability to hold static positions without breaking.

 

References:

  1. Hungate, Joel, Using 3-Dimensional Motion Analysis to Evaluate the immediate effects of a novel, wearable corrective training device on Biomechanical mobility, stability, asymmetry, and vulnerability to Musculoskeletal injury, DARI Motion Internal Validation, 2018.
  2. Mosier et al, Movement Analysis via Motion Capture System Helps Identify Injury in At-Risk NCAA D1 Football Players—A Preliminary Study, NSCA, Indianapolis, 2018
  3. CMSgt Joshua Smith, USAF BA Prep Superintendent Lackland JBSA: Integration of Technology into the Daily Training of a Battlefield Airman Candidate, TSAC, April, 2018 Norfolk, VA.
  4. Moodie, Patrick, Internal DARI Motion Reproducibility Master Validation, Data on file with FDA 510k Submission.
  5. Zhu L, Sulsky SI, Bulzacchelli MT, Hill OT, Kardouni JR. “Risk factors for training-related injuries during U.S. Army basic combat training.” Oral presentation, Military Health System Research Symposium. August 15-18, 2016. Orlando/Kissimmee, FL.
  6. Sulsky SI, Bulzacchelli MT, Zhu L Kardouni JR, Hill OT. “For want of a nail: Incomplete data and missing documentation in administrative data hamper medical research.” Poster presented at the Military Health System Research Symposium. August 15-18, 2016. Orlando/Kissimmee, FL.
  7. Knapik, JJ, Canham-Chervak M, et al. Discharges during U.S. Army basic training: injury rates and risk factors. Mil Med, 2001;166(7):641-7.
  8. Tactile input principle: http://neuropedicspt.com/blogforprofessionals/2015/8/30/proprioceptive-input
  9. Co-contraction/Force Coupling: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257849/ https://caloriebee.com/workout-routines/Exercise-for-Stomach-Muscles
  10. Reliability of military tests to assess readiness for combat related duties (1)
  11. Brown, E 2003 thesis (1)
  12. Prediction of simulated battlefield physical performance from field expedient tests
  13. Postural Control in Dual-Task Situations_ Does Whole-Body Fatigue Matter_
  14. Functional training bridge to return to duty (1)
  15. Factors That effect movements
  16. https://www.physio-pedia.com/Fryette%27s_Laws_of_Spinal_Motion
  17. https://www.ncbi.nlm.nih.gov/pubmed/7701385
  18.  https://www.aaronswansonpt.com/force-coupling-for-the-lumbo-pelvic-hip-complex/

RESEARCH AND CASE STUDIES:

First is Fryette laws of spinal motion.  Interesting research based knowledge of how the spinal is dysfunction as it related to muscle activation and how to correct it.
 
More research for the anatomy of how the lumbar spine stabilization with force coupling with contralateral muscles groups.

Proprioceptive Neuromuscular Facilitation Objectives

  1. Define PNF (Proprioceptive Neuromuscular Facilitation).

Proprioceptive:  having to do with any of the sensory receptors that provide information concerning movement and position of the body.

Neuromuscular:  pertaining to the nerves and muscles.

Facilitation:  to make easy.

Definition: to stimulate a change in neuromuscular response toward normal function

 

  1. Describe the three principles of neuromuscular re-education.

 

  1. Repeated activation of the nerve pathways from the brain to the muscle results in increased power, endurance, coordination and ability to repeat the motion with less effort and concentration. To achieve these two things are used: Maximal resistance and Motion through full available ROM.
  2. Muscles are reciprocally innervated. This allows a person to achieve maximum force in the desired direction since antagonist’s muscles are relaxing.
  3. A maximal muscle contraction depends on the quantity of motor units being excited and the frequency with which the signal is being sent from the brain to muscle.

 

  1. Define facilitation and identify its philosophy of treatment in neuromuscular reeducation.

Facilitation: to make easy

  1. The treatment approach is always positive, reinforcing and using that which the patient can do, on a physical and psychological level.
  2. The treatment is aimed at improving the patient’s performance of functional activities.

 

  1.     Describe the PNF principles of overflow, diagonals with rotation, and the developmental sequence.            
  2. Overflow – This is the principle of the strong helping the weak, the stronger muscles groups within a pattern and stronger patterns are utilized to increase the response of the weaker muscle groups.

 

  1. Diagonals – They are representative of the mass movement pattern characteristic of the normal motor activity. Each diagonal contains three components of motion: extension/flexion, abduction/adduction, and rotation, which is the most important for treatment.
  2. Developmental sequence – It is representative of how we all developed from infancy to adulthood. This means first achieving some movement, then trunk control, then the movement of the extremities on a stable trunk, and lastly skilled activities.
  3.  Describe sensory modalities and their components (if applicable) used in facilitation and select facts concerning each.        

Proprioceptive input: 

  1. Quick Stretch – facilitation of muscle contraction, always followed by resistance.
  2. Maximal Resistance (appropriate for muscle) – proper use results in irradiation.
  • isotonic contraction-greatest resistance which allows full range of motion.
  • isometric contraction-greatest resistance without breaking the hold.
  1. Traction and Approximation-traction stimulate motion (Upper Extremities), approximation stimulates stabilization in weight bearing positions (Lower Extremities).

 

           Exteroceptive Stimulation:

   

  1. Manual Contact-facilitation and guidance by grip and pressure, gives tactile stimulation. Touch only surface to be stimulated, avoid circumferential grip, practice lumbrical grip.
  2. Temperature Change- cold or hot.

 

        Normal Timing- sequence of muscle contractions resulting in a coordinated movement.

 

        Vestibular Stimulation – slow movement which inhibits tone, or fast which can be considered facilitation.

Verbal Commands – Vocal volume as stimulus to guide motion and facilitate power.  Tone of voice influences quality of response.  (Strong=maximal response; soft=relaxation and security for pain patients).   Commands are clear and concise, accompanied by motion.

Visual Cues- Vision facilitates coordination of head and trunk with movement, leads movement, helps the patient in recognizing the direction of movement.

       

 

  1. 6. Identify the method of employing and the purpose of each of the following techniques and their components: directed to agonist; reversal of antagonists; and relaxation.

 

  1. Directed to Agonist :
  2. Rhythmic Initiation (RI) – begins with passive movement through full range of motion followed by active-assistive movements, progressing to resisted movements.
  3. Repeated Contraction (RC) –repeating the desired pattern to promote the learning process and to help develop strength and endurance. A quick stretch in the middle of range of motion (or point of weakness) helps promote this response, followed by resistance.
  4. Reversal of Antagonists:
  5. Slow Reversal (SR) – an isotonic contraction through the diagonal pattern with a shift in manual contacts to resist the opposing diagonal pattern.  The manual contact shift must be performed smoothly so that the patient can effectively move from one pattern to another.
  6. Rhythmic Stabilization (RS) –gradual isometric contraction of antagonistic and agonistic patterns, which results in co-contraction of antagonists if the isometric contraction is not broken by the therapist.
  7. Relaxation:
  8. Contract-Relax (CR)- an isotonic contraction of the antagonist, allowing rotation against maximal resistance, but not of the other components, followed by relaxation.
  9. Hold-Relax (HR) an isometric contraction is performed of the range of motion-limiting antagonist, increasing resistance, followed by relaxation and passive movement into new range of motion.

 

  1. Given a list of proponents of facilitation, and a list of characteristics, match the proponents to their appropriate characteristics.

Other Proponents of Facilitation:

  1. NDT (Bobath) – normalizes tone, inhibits synergies, and uses developmental sequence.
  2. Movement Therapy (Brunnstrom) – uses synergies for hemiplegia treatment.
  3. Sensory Stimulation (Rood) – uses brushing and icing as peripheral stimulation.
  4. Compensatory Training –substitution is used to achieve independence.
  5.    Discuss the stages of motor control.
  6. Mobility – discrete movements not well controlled, getting range of motion.
  7. Stability – maintain position in a weight bearing, antigravity position.
  8. Controlled Mobility – moving while maintain posture.
  9. Skill – highly coordinated movement.